Provider Demographics
NPI:1649710682
Name:VALUE HEARING (FAIRFIELD) LLC
Entity type:Organization
Organization Name:VALUE HEARING (FAIRFIELD) LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-218-4100
Mailing Address - Street 1:2281 LAVA RIDGE CT
Mailing Address - Street 2:STE. 130
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2801
Mailing Address - Country:US
Mailing Address - Phone:916-218-4100
Mailing Address - Fax:
Practice Address - Street 1:1371 OLIVER RD
Practice Address - Street 2:STE. B
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3470
Practice Address - Country:US
Practice Address - Phone:707-999-7530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALUE HEARING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment